Without Exception: Reclaiming Abortion, Personhood, and Freedom

by Pam Houston

Without Exception is an unflinching call for freedom by way of abortion rights.

"A story told with honesty. I thank Pam Houston for this timely and timeless book" —CAMILLE T. DUNGY, The Story of a Black Mother's Garden

Written with equal parts candor and lyricism, Pam Houston illuminates the interconnected histories of abortion in the United States and in her own life during the decades when Roe v. Wade was the law of the land. Houston guides us through the shifting landscapes of politics, the law, and self-determination in a country where access to medical care and the power to determine your own destiny are increasingly—and once again—dependent on geography and circumstance.

Genres: Nonfiction, Feminism, Social Justice, Politics, Activism, Memoir, Health

170 pages, Kindle Edition

Published September 3, 2024

About the author

Houston is the Director of Creative Writing at U.C. Davis. Her stories have been selected for the Best American Short Stories, the O. Henry Awards, the Pushcart Prize, and the Best American Short Stories of the Century. She lives in Colorado at 9,000 feet above sea level near the headwaters of the Rio Grande.

Reviews

[Rebecca · Rating 5 out of 5]

If you’re going to read a polemic, make sure it’s as elegantly written and expertly argued as this one. Houston responds to the overturning of Roe v. Wade with 60 micro-essays – one for each full year of her life – about what it means to be in a female body in a country that seeks to control and systematically devalue women. Roe was in force for 49 years, corresponding almost exactly to her reproductive years. She had three abortions and believes “childlessness might turn out to be the single greatest gift of my life.” Facts could serve as explanations: her grandmother died giving birth to her mother; her mother always said having her ruined her life; she was raped by her father from early childhood until she left home as a young adult; she is gender-fluid; she loves her life of adventure travel, spontaneity and chosen solitude; she adores the natural world and sees how overpopulation threatens it. But none are presented as causes or excuses. Houston is committed to nuance, recognizing individuality of circumstance and the primacy of choice.

Many of the book’s vignettes are autobiographical, but others recount statistics, track American cultural and political shifts, and reprint excerpts from the 2022 joint dissent issued by the Supreme Court. The cycling of topics makes for an exquisite structure. Houston has done extensive research on abortion law and health care for women. A majority of Americans actually support abortion’s legality, and some states have fought back by protecting abortion rights through referenda. (I voted for Maryland’s. I’ve come a long way since my Evangelical, vociferously pro-life high school and college days.) I just love Houston’s work. There are far too many good lines here to quote. She is among my top recommendations of treasured authors you might not know. I’ve read her memoir and her short story collections, and I’m already sad that I only have four more books to discover.

Originally published on my blog, Bookish Beck.

[Alyson · Rating 5 out of 5]

I owe so much to this writer. As a young woman, she helped me understand why I did what I did and loved who I loved. Well before we used words like "toxic masculinity" and mountain towns became unaffordable for girls born to the working-class poor like me. I have to admit that I avoided this book because I did not hold faith that young women would show up to the polls angry and I had less faith that men who benefitted/benefit from abortion would speak up. This election did not surprise me.

But when my public library queue served this up in the middle of a very tough week, I read, wept, and grieved for my younger self. I loved this book, and it was exactly what I needed.

Many many favorite quotes, but these were the one ton bell clanging in the universe for me:

Mothers:
"For a lot of my life, I wished for a mother who did not believe she had given up everything she loved to have me, whose existence was literally shattered by the fact of my presence in the world. Only now do I understand those were the circumstances that allowed her to give me the gift of childlessness. And childlessness might turn out to be the single greatest gift of my life."

Healthcare:
She drove herself to the emergency room, stopping to throw up every couple of miles, and when she saw the doctor, he asked what her pain was on a scale of one to ten. My friend runs ultramarathons, has broken many bones, is quite familiar with pain, and she answered him truthfully that her pain was at a ten.
He chuckled, looked her up and down, said, "You haven't had kids, have you."

Being a US citizen who carries crushing debt just to have had the privilege of being a student:
"In my opinion, the single smartest thing anyone had ever said was when James Baldwin said this: "I imagine one of the reason people cling to their hates so stubbornly, is because they sense once hate is gone, they will be forced to deal with pain."
I work hard not to hate the accused sex offenders sitting on the Supreme Court, the men tracking their wives across state line with their cell phones, the guy who lives not too far from me who spray painted his truck with kung flu on one side and baby-killer on the other. I don't always succeed, but I work at it because I knot it feels worse to hate than to be hated. I work at it because I understand being hated is one price of being free."

[Rebecca · Rating 4 out of 5]

Thought-provoking, not only of the capacity and agency of women in current society but also of the concept of our individual roles in society. My favorite essay describes Keats’ concept of “negative capability”, which is “the capacity to contain and tolerate anxiety and doubt, to demonstrate the courage in the face of unknowing”. May we extend mercy and build our own negative capability amidst another’s story.

[Ines · Rating 5 out of 5]

I’ve never needed an abortion, and I don’t even live in the U.S., but this book still landed like a punch to the sternum. Without Exception is not “American politics in book form.” It is a precise, unflinching examination of what women everywhere endure, and what far too many people, especially men, prefer not to acknowledge.

This should be required reading for women, yes, but men especially need to sit with it. The comfortable distance between “I’m a good guy” and “I actually intervene, speak up, or take responsibility” is exactly where this book applies pressure. Anyone who thinks they are exempt will find out quickly that they are not.

Pam Houston is ferociously brave here. She excavates her own trauma with zero sugarcoating. She refuses to soften anything for the reader’s comfort. There is no hand-holding. No selective editing. Just the reality women live with, told in the plain, devastating language it deserves.

This book absolutely warrants a full trigger warning list, not because it is gratuitous, but because the honesty is so direct it overrides every emotional defense you have. I spent entire sections nauseous, furious, and heartbroken. Every chapter forces a confrontation with the violence, apathy, and cultural rot we have learned to tolerate. It repeatedly left me asking how this is still (again?) the world we live in.

By the time I reached the end, the emotional damage was total. Houston does not let you look away, and she does not give you a place to hide. The cumulative effect is brutal in the way truth often is. It is clarifying, enraging, and impossible to forget. This is not a book you “finish.” It is a book that rewires how you see silence, complicity, and the quiet accommodations people make to keep the world comfortable for perpetrators. It demands something from you, and once you have read it, indifference is no longer an option. I will be pressing it into the hands of anyone who thinks this topic is distant, exaggerated, or someone else’s problem.

[Marion · Rating 5 out of 5]

Brilliant. Ten stars! Pam Houston is the bomb.
First read August 2024.
10-17-24: read again. First re-read of many most likely.
Thanks to the incomparable Torrey House Press for providing multiple copies to send to my friends.

[Wendy · Rating 5 out of 5]

Everyone in the U.S. should read this book! Very highly recommended.

[Charlotte Taft · Rating 5 out of 5]

Powerful and vulnerable

Pam Houston is beloved for her honesty and courage as well as for her lyrical writing. In this excellent book she brings us face to face with facts that many of us don’t want to know. She invokes the sacred feminine and illustrates how thoroughly it terrifies the patriarchal system, and how violently and systematically it is
brought to heel. For the past half-century my work has been to help women make pregnancy choices that ensure their sense of wholeness. And to help women find resolution and healing after abortion in a world that feeds off and requires their shame. My videos at beforeandafterabortion.com are designed to assist women in showing themselves grace and mercy no matter what choices they make.

[Kirstin · Rating 4 out of 5]

“The freedom to control what happens to one’s own body is not only the foundation for gender equality, it is the foundation upon which all other human rights are built.”

Pam Houston is a storyteller of and advocate for our land and environment. So, there can be no more fitting person to pen a polemic on abortion then someone who recognizes that the way that one treats the Earth is related to how one treats their mother (or sister, or daughter).

At times, I felt this book was cathartic, giving voice to many of my own thoughts and frustrations. In other moments I noticed myself gripping the pages of the book I bit too tight. Pam Houston weaves her real-life experiences with statistics, news stories and court cases regarding abortion.

From the joint Supreme Court dissent when Roe v Wade was overturned, “one result of today’s decision is certain: the curtailment of women’s rights, and of their status as free and equal citizens.”

I now close my review, as Pam Houston closed Without Exception, with a brilliant Toni Morrison quote worth living by, “ I tell my students, when you get these jobs that you have been so brilliantly trained for, just remember that your real job is that if you are free, you need to free somebody else. If you have some power, then your job is to empower somebody else. This is not just some grab-bag candy game.”

[Ann Kennedy · Rating 5 out of 5]

Spot on. A personal story that never loses sight of the bigger issues. A call to action, education & awareness. Highly recommend.

[Tiana Ross · Rating 4 out of 5]

I learned a lot about abortion rights and Roe v. Wade reading this short book. The undertone of female rage was definitely felt throughout, so get ready to be mad! I had to put it down and take a breath once in a while because the author's personal experience was so horrible it made me wince. I imagine it was healing to write.

[S Grylls-Murphy · Rating 4 out of 5]

Not for everyone but it was for me. Pam made some excellent observations and backed up her opinions. I am glad I am a sixty something, American woman who had the advantages of Roe v Wade and the ability to decide my own future.

[Clare Vergobbi · Rating 5 out of 5]

Wake up sheeple, the dystopia is already here.

(Lucid, vulnerable, well-argued, beautiful, and infused with a simmering rage and determination. I imagine few people who aren’t already proponents of abortion access and reproductive rights will pick up this book, but oh if only they would.)

[Barbara · Rating 5 out of 5]

Excellent!! Thank you, Pam Houston, for your courageous writing. And thank you, Marion, for the recommendation.

[Jennie Greenstein · Rating 5 out of 5]

Loved this reminder of all the reasons women should rule the world

[Jesse Coulson · Rating 5 out of 5]

A very, very, very important book.

[Megan · Rating 5 out of 5]

Written in 60 mini-chapters, this memoir-esque elegy to women’s rights is beautifully written and utterly human.

[Zoë · Rating 3 out of 5]

3.5

[Cordelia · Rating 5 out of 5]

A lyrical reminder of why I am currently a single issue voter

[Crisanne · Rating 5 out of 5]

Raw, devastating and true.
This book made me cry multiple times and made me feel seen and heard like connecting with a best friend. How can we love ourselves and those around us to make this world a better place for all beings? What does your love in action look like?
Required reading.

[Eve · Rating 5 out of 5]

Everyone MUST READ THIS BOOK. POWERFUL. MIND-BLOWING. FREEING.

[Meagan · Rating 5 out of 5]

What a powerful, brave, and important little book. It’s like a light shining on a topic that has been hidden in the dark for far too long. This book will show readers the truth about abortion, as well as how women’s health in general is suffering in a post-Roe United States. The connection made between abortion laws and the treatment of the environment made this book all the more moving to me. I will be trying to get as many people as I can to read this before Election Day.

[Mark Stevens · Rating 5 out of 5]

There’s a war on women. There’s always been a war on women. This country, that country. Well, by many accounts Denmark is doing a pretty good job with pay equality but according to what I read, it’s not perfect. Afghanistan isn’t a great place to be a woman and there are plenty of countries in Africa and across the Middle East where, if you were born with two XX chromosomes, your journey through this world is going to involve a dramatically different ride than your male counterparts.

It’s not a pretty picture in the United States, where women earn 82 percent of what men earned for doing the same job (2022 statistics). There’s been progress. In 1982, it was 65 percent (Pew Research Center data.) What’s weird, of course, is that it makes no sense. What’s weird is that it persists. The problem is fixable—pay women the same as men. There, done.

It’s also possible to fix the war on women when it comes to abortions and healthcare. The problem is fixable. Let women choose. There, done.

I happen to agree with Pam Houston—it’s a war. It’s about power. It’s about control. It’s about taking away basic freedoms and, as I’m writing this one week before the 2024 election, we might soon backpedal further. The issue isn’t about banning abortions only. It’s about monitoring women. Soon, it will be access to contraceptives and, well, five gears in reverse. Here we go.

“The problem is the dominant cultures’ radical fear of mystery, their incessant desire to control and often annihilate anything they don’t understand,” writes Houston in Without Exception: Reclaiming Abortion, Personhood, and Freedom. “The mystery of the land, the mystery of a woman’s body, the mystery of a polar bear, of a melting ice sheet, of healing ourselves and the earth, of God, of gender fluidity, of difference, of not knowing, of the precarious future, of our impending deaths, and of life in all its mind-expanding, soul-exploding, heart-annihilating array.”

Yes, we are afraid of equality. We must be afraid. What else explains it? There’s no logic to it because fear and logic don’t connect.

Then-Senator Kamala Harris in 2018: “Can you think of any laws that give the government the power to make decisions about the male body?”

Then-Supreme Court nominee Brett Kavanaugh during his confirmation hearing: “Um.”

There was a bit more to the exchange, but that was basically the response. There are no laws that keep men from making decisions about their own body. But the oppression of women continues and the negative spiral down is happening now, as Houston writes, faster than we can keep up. While many states are voting this fall to protect a woman’s right to abortion, we know they won’t all pass.

What makes Houston’s quick-read treatise is it’s so clear, so emphatic. Here’s the opener:

“For forty-nine years, five months, and two days, the United states Supreme Court protected a woman’s right to have an abortion. In other words, it protected a woman’s right to determine what happens inside her own body, and in the long winding road of her future, and in the shape of her one precious life, in the case of unwanted pregnancy. It protected this right whether she was twelve years old and had been raped by her father or another male relative, whether she was twenty-two and date raped after she’d had her cocktail drugged in a bar the first time she spent a summer interning at a nonprofit in a big city, whether she was forty-two and happily married and already had four children and the family budget was stretched beyond manageability, whether she was just dedicatedly single and entirely career focused and had thrilling unprotected sex with strangers every chance she got.”

Well, doesn’t that sound like a reasonable world? Raped by your father, doesn’t an abortion seem like a fair option to have at your disposal? Raped by another male relative, too? Same with the drugs in your drink or for any reason? Without exceptions?

Houston, who has strong concerns about global overpopulation and the ability of the world to take care of the existing eight-plus billion souls, let alone anymore human beings, walks us through each of her three abortions. She parses federal and state court decisions around the legality of abortions. She touches on the horrific abuse she suffered from father. She writes about friends and other writers she’s met on her writing journeys around the world. She quotes the brilliant Barry Lopez and the insightful James Baldwin, both to great effect. No surprise, Without Exception is written beautifully.

But it’s an acquaintance—a male acquaintance—who gives Houston the clearest insight of all, that male-dominated anti-abortion efforts aren’t about babies, they are about controlling women “because they fear the power women have, when they get together, when they are not overburdened, when they are free to organize …”

Houston writes that she knows she’ll be called an “angry woman” for writing Without Exception but that she’s mostly heartbroken that “woman’s bodies are still owned by rich men, that the earth is dying at our hands and we are doing too little to save or assist or even console her, and that many of those who wish not to contribute to the teeming masses who are consuming every last resource at lightning speed will now be forced, by those same rich men, to give birth to more consumers.”

Without Exception will take you a few quick hours to read. It’s worth every minute. There’s a war going on. Looking the other way doesn’t cut it. There is no neutral ground.

[Cassandra · Rating 2 out of 5]

2.5 stars. It’s very on theme of this book for me to have complicated feelings about it. While I really enjoined the intertwining of history and memoir it began to feel rather navel gazing at times.

I also just downright took issue with some of the things she said. It began to get a bit “white guilt-y” in parts and I rolled my eyes to the back of my head when she said “I am personally willing to do my part to not bring another white person into this world.” Girl shut uppp if we said that about any other group of people you would be having a fit. My future children will be half white and half indigenous Latino. Is that too white to exist according to this author? You can fight for equality without doing this whole weird end white people thing.

The author also says that the TRAP law of clinics needing admission rights to hospitals is just a way to prevent them from performing abortions and not necessary. I could not disagree more. I was caught up in this when I had an issue in Planned Parenthood (which was being protested when I walked into it) where I needed to be referred to a hospital and they simply just couldn’t do it and I was sent home during COVID to just figure it out myself when no one was accepting walk ins. So it’s deluded to say that clinics do not need that capability.

And finally… I understand that the author doesn’t want kids. She doesn’t need to ever want kids. But it just became so self involved with all of these things that she does and can experience because she doesn’t have children. When the author herself said that “feminism is every woman’s right to her own story.” People don’t need to not want children so that they can horseback ride in Iceland. And (some) women with children can very well still go do that. And there are many women without children that would never have access to that anyway. It started to just feel like a weird way to brag on all her adventures.

Oh but how could I forget. This book is absolutely filled with statistics with not a single reference or citation. Her source? “Just trust me bro.” Anyway with all of that being said I enjoyed the writing style.

[Shireen · Rating 5 out of 5]

It's rare to find a book that can lean into laying out the facts about maternal mortality and changing abortion laws, sharing devastating and powerful stories, and talk about extending mercy even when we disagree. This was a hard book to read, but it is also needed given the world we live in.

Some excerpts:
- Worldwide, the US ranks sixty-fourth in maternal morality. In other words, sixty-four countries are better at taking care of mothers than we are, some of them by a lot. For example, you are ten times more likely to die of pregnancy and childbirth related to complications in the US than you are in good health care countries like Iceland and Norway and Spain... What all of this means is that the US government is forcing women to risk their lives by taking pregnancies to term and giving birth, but they are not investing time or money to find out why so many of them are dying, nor are they working to improve those numbers, nor are they providing adequate postpartum care or a social safety net to help that child of rape or incest or failure of birth control or accident of passion, thrive.
- I am certainly no expert on the subject, but I don't believe Jesus would have wanted a ten-year- old to be forced into having her father's baby. I don't believe Jesus would have wanted children to die of dysentery in holding pens, blanketless, on the southern border. I don't think Jesus would have been into banning books...
- Mercy is defined as compassion or forgiveness shown towards someone whom it is in one's power to punish or harm. Imagine what it would be like to live in a country where the candidate we voted for was the one we thought most likely to show people who are suffering compassion and forgiveness. Imagine a government who held mercy as its highest goal. Imagine living within a system who supported people in loving whom they loved, in dressing how they liked, in being who they were. Imagine what that kind of mercy would look like. Now imagine how your life would change if you showered that much mercy on yourself.

[Todd · Rating 5 out of 5]

It feels like an understatement to say that Pam Houston puts together a powerful argument for the legalization of women's health. Since I am just slightly older than her, we have spent a significant part of our lives with women's health, demonized as "abortion" by the "pro-life" folks, being endlessly debated. Who would have thought that a Supreme Court corrupted by personal preferences rather than the law would erase 50 years of precedent to further endanger the lives of mothers and the unborn?

Pam has told her personal story unflinchingly. She's done the deep dive on the consequences as women's health declines. I hope it helps to turn the corner on the language whose meanings have been reversed by those with bad intentions.

We should have known this was coming. I believed it would when I ran for the Wisconsin State Assembly in 2004, but other than protesters outside of my business most people didn't want to talk about it. But Republican state legislators around the country were busy crafting laws to restrict and intimidate, waiting for the day when their party and the courts would be corrupted beyond recognition. Now a new generation will have to fight for the rights their mothers and grandmothers had.

I had the honor of meeting Pam at the bookstore I worked at when she came for an outdoor reading during the pandemic. I already was impressed by her writing, but I was doubly impressed that even with her health compromised, she showed up and spoke her truths. She had an inner strength that overcame what would have kept many of us at home in bed.

It will take many of us to emulate her strength and overcome the collapse of our government. It's time we all show up.

[Karalee James · Rating 4 out of 5]

there’s a reason I haven’t read that much on abortion since I did my BSW capstone on it, it literally puts me into the craziest fucking rage.

Abortion laws are only a way to control and own women’s bodies, it has nothing to do with the protection of babies. Abortion restrictions are NOT put in place because law makers have compassion.

I am SOOO mad (and we all should be!!) that so much effort is put into protecting unborn fetuses but no one gives a SHIT about maternal mortality rates and the absolutely traumatic birth experiences that people have in US hospitals because women/birthing people are literally seen as animals and unborn fetuses are more important than them!!!!

Reading about these topics makes me want to barf and rip my hair out and scream at men and just kms tbh. But it’s also something I’m INCREDIBLY interested and invested in and won’t ever stop caring about so it sucks ass.

“I am heartbroken for the pregnant girls and women who will kill themselves because they can't find enough hope or enough money or someone who will risk being sued to drive them across a state line. For the families for whom one more mouth to feed sends them over the edge into poverty, into divorce, into chaos.

I am heartbroken that as a population we have turned a blind eye to the wisdom and generosity and respect and cooperative spirit the people who tended these lands before colonization offered to show us, that as settlers we became slaves to abstractions like money and progress and power, when we ought to have revered mountain and forest, ocean, and sky” (144).

TW: R**e

[Cari · Rating 5 out of 5]

Please read this book. If you are a vagina- having person or you know someone with a vagina, please take a couple of hours and read through this series of short essays. Yes, it's centered around abortion but it's so much more than that. All people deserve the right to choose what happens in their own body.

I will be bribing my young adult children to read this (book recs from mom aren't always well received 😅), but I think everyone needs to read it.

I don't generally annotate books, but I felt compelled to do so with this one. A few of my highlights:

"Fear always sounds more innocent than hate, less violent, but I am not sure, after all, that it is."

"A study out of the University of Pennsylvania found that restricted access to abortion increased the risk of suicide among women of reproductive age for more than four decades."

"Sandpoint, ID stopped keeping track of their maternal mortality..."

"About 36% of counties in the US have been identified a maternity desserts, which is defined as a county with no hospital that is stated appropriately to provide medical care for pregnant people and no obgyns or certified midwives."

"It's alright if the life you choose belongs to you."

There are so many more poignant and thought-provoking statistics, quotes, anecdotes, etc, and i can't possibly write them all.

[Tad · Rating 5 out of 5]

Part memoir, part history, part polemic. This book walks a tricky line trying to navigate all of that but Houston handles it deftly. She traces the history of abortion rights in this country while interweaving her own history with abortion and the current status of abortion in this country. It’s heartbreaking, infuriating and inspiring all at once. It’s also very short but doesn’t feel too short. There’s some really harrowing stuff in here. And as a long time reproductive rights advocate, this made me mad and fired up. Wild reading this just a couple days before the election. But I found this deeply moving and much needed. A reminder of what is at stake in this and future elections. And a powerful call to action. We cannot go back.

[Greta]

Labai gražiai suformuluotas pro-choice (o tiksliau pro-woman’s-life) argumentas. Idėjine prasme nieko naujo, bet autofikcijos elementas pakelia tekstą į aukštesnį lygį. Autorė pasakoja apie tai, kaip gimusi tapo akmeniu po savo motinos kaklu ir kaip nusprendė pati to akmens nesikabinti. Koks gražus dalykas yra pasirinkimas. Norėtųsi, kad tas savo gyvenimo, sveikatos ar principų pasirinkimas taptų savaime suprantamas – bet,mano spėjimu, toks taps tik kai nėštumas bus visiškai atsietas nuo moters kūno.

[Kate · Rating 5 out of 5]

REQUIRED READING in this exact place and time.

"What kind of country offers no exceptions for rape and incest?"

"I wonder, when these judges and legislators sign off on an abortion law that makes no exception for rape or incest, if they give any thought to the particular hell they are damning the women in their constituency to. That’s not true either. I don’t really wonder. I know many of these lawmakers have a vested interest in normalizing rape and incest."